Autoimmune markers and autoimmune disorders in patients with postural tachycardia syndrome (POTS)
Abstract
Objective In recent years, there have been a number of studies suggesting that POTS may have an autoimmune etiology. This study examined whether the prevalence of antinuclear antibodies (ANA), other markers of autoimmunity and co-morbid autoimmune disorders is higher in patients with POTS than in the general population. Methods and results Medical records of 100 consecutive patients with POTS evaluated at our clinic were reviewed. In this cohort (90% females, mean age 32, range 13-54 years), 25% had positive ANA, 7% had at least one positive aPL antibody and 31% had markers of autoimmunity. When compared to the general population, patients with POTS had a higher prevalence of ANA (25% vs. 16%, OR 1.8, CI 1.1-2.8, p Conclusion Patients with POTS have a higher prevalence of autoimmune markers and co-morbid autoimmune disorders than the general population. One in four patients have positive ANA, almost one in three have some type of autoimmune marker, one in five have a co-morbid autoimmune disorder, and one in nine have Hashimoto's thyroiditis.
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Blitshteyn determined a high prevalence of positive ANA and other autoantibodies and a high prevalence of comorbid autoimmune disorders in patients with POTS.
“Blitshteyn recently determined the high prevalence of positive ANA and other autoantibodies and the high prevalence of comorbid autoimmune disorders that exist in patients with POTS.8,9”
From Autoimmune postural orthostatic tachycardia syndrome (2018) · cites this paper as [8]
Positive antinuclear antibody tests occur in one of four POTS patients, and 20% report a history of autoimmune disorders such as Hashimoto's thyroiditis, rheumatoid arthritis, or Sjögren syndrome.
“For instance, positive tests for antinuclear antibodies can be found in one of four POTS patients, whereas 20% report history of autoimmune disorders such as Hashimoto's thyroiditis, rheumatoid arthritis or Sj€ ogren syndrome [40]”
From Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management (2019) · cites this paper as [40]
Indicators of immune system dysfunction and positive autoimmune tests are frequently seen among POTS patients.
“Secondly, indicators of immune system dysfunction and positive autoimmune tests are frequently seen among POTS patients.”
From Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management (2019) · cites this paper as [40]
In patients with POTS, thyroid autoantibodies-against the TSH receptor, thyroglobulin, and thyroid peroxidase-occur at a higher prevalence than in the general population.
“Thyroid gland [40, 41]”
From Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management (2019) · cites this paper as [40]
Induced alpha-1 and beta-1 adrenergic receptor autoantibodies in rabbits resulted in an exaggerated pulse response to 60° tilt.
“Induced alpha-1 and beta-1 adrenergic receptor autoantibodies in rabbits resulted in an exaggerated pulse response to 60° tilt in these animals.”
From Sinus Tachycardia: a Multidisciplinary Expert Focused Review (2022) · cites this paper as [107]
Blockade using a proteolysis resistant decoy peptide mimicking putative epitopes for these autoantibodies returned the postural pulse response to normal, supporting a pathophysiological role for autoantibodies in this animal model.
“Blockade using a proteolysis resistant decoy peptide mimicking putative epitopes for these autoantibodies returned the postural pulse response to normal, supporting a pathophysiological role for autoantibodies in this animal model107.”
From Sinus Tachycardia: a Multidisciplinary Expert Focused Review (2022) · cites this paper as [107]
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Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management
Fedorowski, A. (2019) · Journal of Internal Medicine · doi:10.1111/joim.12852 · Cited by 352 · see citing works
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“Positive (though often non-specific) autoantibody tests are frequently seen among POTS patients, and about 20% report a history of an autoimmune disorder such as Hashimoto’s thyroiditis, rheumatoid arthritis or Sjögren syndrome (Blitshteyn, 2015; Shaw et al., 2019).”
InfluentialPediatric Disorders of Orthostatic Intolerance
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“The prevalence of anti-gAChR antibodies in this study was higher than that in previous study.17 Anti-gAChR antibodies may impair autonomic ganglionic synaptic transmission, and antibodies that interfere with ganglionic transmission may contribute to dysautonomia in patients with POTS.18 Although POTS is pathophysiolog…”
BackgroundInfluentialSinus Tachycardia: a Multidisciplinary Expert Focused Review
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- Authors
- Blitshteyn, S.
- Affiliations
- University at Buffalo, State University of New York (US)
- Corresponding author
- Blitshteyn, S
- ORCID
- Blitshteyn, S
- Venue
- Lupus
- Publisher
- SAGE Publications
- Published
- 2015-06-01
- Volume
- 24
- Issue
- 13
- Pages
- 1364-1369
- ISSN
- 0961-2033 (ISSN-L)
- 1477-0962
- OpenAlex
- W1572020852
- Cited by
- 116
- References
- 3
- Citations by year
- 2026: 10 · 2025: 8 · 2024: 19 · 2023: 12 · 2022: 12 · 2021: 12 · 2020: 17 · 2019: 7 · 2018: 12 · 2017: 4 · 2016: 3
- FWCI
- 6.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Lupus (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- postural orthostatic tachycardia syndrome, autoimmune markers, antinuclear antibodies, antiphospholipid antibodies, autoimmune disease comorbidity, Hashimoto's thyroiditis, rheumatoid arthritis, systemic lupus erythematosus, chronic inflammatory demyelinating polyneuropathy, celiac disease, autoimmune etiology, women, young adults
- MeSH terms
- Adolescent, Adult, Antibodies, Antinuclear, Arthritis, Rheumatoid, Autoantibodies, Autoimmune Diseases, Female, Humans, Lupus Erythematosus, Systemic, Male, Middle Aged, Biomarkers, Autoimmunity, Prevalence, Hashimoto Disease, Postural Orthostatic Tachycardia Syndrome
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